This overall program project in trauma is designed to quantitatively evaluate various biochemical and physiological parameters in the critically ill patient. The pathophysiology of trauma has been expressed by a number of overt clinical changes manifested by the patient which have served to emphasize the severity and seriousness of trauma, "the forgotten disease." This program has been conceived to explore in depth the clinical changes with the hope of providing a better rationale for the treatment and care of such patients. The stage of this research rightfully belongs to the holder of the expertise in research and patient care and facilities to care for such patients. We feel that these credentials are held by the facilities and staff of the Medical College of Ohio. The Trauma and Surgical Intensive Care Units and the supporting Metabolic Unit will provide the basis for the constant clinical care of the patient and for research by the basic scientist. The program encompasses study areas in metabolism, ventilation and circulation. The interaction of the Departments of Surgery, Anesthesiology, Medicine, Neurosciences and Biochemistry is evident in the various sub-proposals of this application.